January 6, 2008 – 3:09 pm
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PHASE 1. KNOWLEDGE
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Community Mobilization
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Formation of Health Clubs
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Creating Common Unity
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Health Promotion
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Home Hygiene Improvements
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| Community Mobilization: A Community Health Club is a new concept that needs to be carefully introduced into an area in the preliminary stages to avoid political suspicion and promote a local sense of ownership of the club as a home grown CBO. This is usually done by the implementing agency, (either NGO project officer, or Ministry of Health field worker), in consultation with local leadership (Councilors, politicians, kraal heads, village elders, religious leaders and headmasters) to explain the idea so that the officials are well acquainted with it before the public are involved. The local leaders then call a public meeting and introduce the idea and the implementing partners. The programme is outlined and those interested are invited to meet and register as members of the health club. |
| Formation of Health Clubs: Membership is voluntary and free, and the club is open to men and women of all ages, religion, levels of education, income and ethnic group. As members can join at any stage of the programme, this encourages wide support. If the club membership exceeds 100, it is often split into two sub groups. At the first meeting, membership cards are issued to each member and plans are made when and where to meet.
CHC Membership Card
The first month is usually dedicated to registering members and establishing the health club leadership. After a few weeks of health sessions, an election is held for Chairperson, Vice Chairperson, Secretary and Treasurer (for future fundraising). The executive committee keeps records of membership and attendance as well as monitoring the facilitator. An inventory of each member’s household (latrine, hand-washing facility, covered water, ladle, soap etc) is done before any session start. This is vital as a base line survey to measure future change. |
| Creating Common Unity: The strength of the Health Club Strategy is that through the sharing of knowledge, understanding, attitude and beliefs, a ‘common unity ‘ is developed in the group that ensures that changes result from a ‘ culture of health ‘ rather than through authoritarian directives from local leadership. Instead of traditional didactic control from above, it is the peer pressure from fellow members at the weekly session that encourages individuals to keep up with the group. Competitions are made between members to encourage compliance with recommended practices. At the most developed level of ‘common-unity’ the health club members undertake to assist the disadvantaged and monitor all health issues arising in the community. Clubs have been involved in outreach child growth monitoring as well as reporting and controlling cholera outbreaks.
Common-Unity through Health Clubs
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| Health Promotion: Health Promotion is the entry point and first stage. A 2 hour session is held every week at a regular time and venue decided by the members. A different topic is selected from the membership card according to season and relevance to the area. The members participate in activities that are designed to engage and amuse them as well as provide a forum for debate and full involvement of each member in the decision making process. These activities are recognized Participatory Rural Appraisal/Participatory Hygiene and Sanitation Transformation (PRA/PHAST) training tools using visual aids specifically designed for the area Those who complete all sessions are publicly recognized with a certificate of full attendance. Each training module takes a minimum of 6 months to a year depending on the season, levels of attendance and need for revision sessions.
Club Member Teaching
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| Home Hygiene Improvements: The Community Health Clubs are not just talking shops where a lot is learnt and little is done. Each week there is a little practical ‘homework’ to be done related to recommended practises to ensure prevention of the disease under discussion. Members pledge to make small changes in their own homestead before the next meeting the following week - the digging of a refuse pit, the making of a dish rack for drying plates off the ground, some means for covering drinking water, the commitment to wash hands in a more hygienic manner. This systematic approach ensures that hygiene progress is made each week. Recommendations usually require little financial outlay but merely reorganisation in the home and better hygiene practise. Behaviour change is sustained by peer pressure and levels of adherence to recommended non-risk practices are exceptionally high. Health Club hygiene has been monitored and cost effectiveness has been well documented over the past decade. (Waterkeyn 1999, 2000, 2003 , Waterkeyn & Cairncross, 2005)
Husband Using Baradza Stand Hand Washing Station
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PHASE 2: APPLICATION/PRAXIS è
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